Contraception in Japan

The Savvy Guide to Safe Sex

Safe sex takes some conscientious planning — and that's when you already know the language and cultural conventions. What do you do when you're looking to get down in Japan but don't want to get knocked up or acquire any other, more sinister, side effects?

The three main approaches to worry-free romps in Japan are condoms, the pill or intrauterine devices (IUDs), while alternative options may be expensive and/or difficult to find. Worry not, however — for those in a panicked frenzy after a night out, the morning after pill is also available.

Condoms

Male condoms are the go-to method for 40.7 percent of Japanese couples (the third highest in the world), according to the 2013 United Nations World Contraceptive Patterns survey. Head to your local pharmacy or a convenience store for a whole slew of options including with lubrication or without, thickness, texture and size. In the same area, you’ll often find bottles of personal lubricant as well as spermicides (殺精子薬; satsuseishiyaku).

If you’re looking to spice up your love life while still being sex savvy, catch-all mega store Don Quijote has an adults-only section with flavored options, alternative textures and more. Specialty stores, such as M’s (Japanese) in Akihabara (which is the size of an actual shopping mall), offer even more options in this department. The mega-popular condom specialty store Condomania (Japanese) offers plenty of unique choices and a wide-range of hilarious condom gag gifts (orange-flavored condoms, anyone?).

The most common Japanese condom brands are Okamoto, Sagami, Kimono and Gorgeous Butterfly, although you’ll also find novelty condoms from time to time, such as those based on popular cartoon characters or famous clothing brands.

A few years ago there were even condoms available in the famous Louis Vuitton print for those fashionistas out there.

On many condom packages, you’ll find numbers proudly displayed in a huge font: 0.1 and 0.2 millimeter, which indicates the thickness of the latex used, with some brands even selling 0.01 condoms designed to feel like nothing at all. These super thin condoms are appealing to those who want the feel of unprotected sex, and despite how thin they sound, they are just as sturdy as the thicker types. While Japanese condoms may seem slightly smaller around the base, their overall length is comparable to western brands.

As a note of caution, be aware that some “big boy” condoms actually just have longer reservoir tips than others. Female condoms, on the other hand, can be found through some online pharmacies but are not commonly used and can run upwards of ¥2,000 for a box of 5 at Rakuten and Amazon Japan.

The Pill

If you’re looking for an alternative to wrapping it up, oral contraception (aka “the pill”) comes in two low-dose forms: monophasic or multiphasic. Getting a hold of the pill can be disgruntling for some women, as neither form is covered by national health insurance and both cost around ¥3,000 per sheet. Medium doses and above are very rare and there are few brands available, while mini pills are not legal at all in Japan.

The pill itself was not legalized in Japan until almost 40 years after the US — in 1999.

Until that point, and even since then by some old-fashioned doctors, they were marketed more as a medication for ‘hysterical’ women, causing somewhat of a stigma in Japan for those women wishing to take them. I had a long-term boyfriend once ask me if I was depressed, because in school he had been told that only women with “hormonal issues” took the pill. The stigma is slowly disappearing, but this is why many people still prefer condoms to other methods of contraception.

Finding the right doctor is key, as regular blood tests are part of the package and many contraceptive prescriptions require monthly renewals. This holds true for other forms of birth control such as IUDs and hormone patches as well — with the latter only recently becoming more widely available. If this is a route you’re looking into, be sure to consult your OB-GYN to find out what your options are.

Intrauterine Devices

Intrauterine devices, aka IUDs or coils, (子宮内器具; shikyunai kigu or 避妊リング; hinin ringu) come in both copper and hormone-releasing types. You have to come in for several appointments before you qualify to receive one, and the devices can range in price anywhere from ¥30,000 to ¥100,000 depending on the clinic and your needs. Out of the two varieties available, copper is much more common, and you’ll need to have your cycle tracked for a couple of months at least before you can get your hands on one of these.

In general, if you are a young, unmarried, sexually active women who is not looking to conceive, or a married woman that has finished having children, you can make the relevant appointments need to get the process of inserting an IUD started.

However, from what I have experienced and heard from other women, some doctors do not provide this method because of the potential complications — such as the device shifting, post-insertion infection or bleeding. The insertion itself is fairly painful but this pain only lasts for a few moments. Some minor bleeding (light spotting for most women I know) will follow. Your doctor will give you some prescriptions for antibiotics and some pain killers, and may require you to make a follow-up appointment for the following week or month. This may or may not be the case for everyone though, so if you are looking to have an IUD inserted, it’s really a good idea to speak to your doctor and have them explain the process to you.

The Rhythm Method

If you’re more of a traditionalist, the calendar or rhythm method is still taught in some schools. Essentially, this method involves you tracking your basal body temperature (with a special thermometer) and gauging the quality/quantity of your cervical mucous (vaginal discharge) over the course of several months. The temperature, mucous consistency and your overall health while determine your ovulation cycle, which tends to vary slightly from month to month. You can find basal thermometers (基礎体温計;kiso taionkei) at any pharmacy for anywhere between ¥2,000 and ¥4,000, and notebooks and phone apps related to tracking your ovulation cycle aren’t difficult to find.

The notebooks are fairly discrete and may even come as part of a regular yearly diary, which means you can keep track of your cycle right alongside your other plans. Some popular apps are Period Tracker Deluxe (iOS, Android), Life (iOS), and Day After — I personally recommend Period Tracker Deluxe as they allow for more customization and aren’t very intrusive with ads or other app recommendations. However, please note that most of these are targeted towards women hoping to conceive, and they may encourage you to get down for that very purpose even when you’re hoping to avoid it.

The Morning After Pill

For those who find themselves in a panic-inducing situation the following morning, Levonorgestrel is available. Commonly known as the morning after pill, it’s a trusted method for post-coital emergencies in Japan, too, but it comes with a few caveats.

If you find yourself in need, you’ll need to go to the doctor and get a prescription up to a maximum of 72 hours after having sex.

They’re not covered by insurance and will run you anywhere from ¥10,000 up to ¥20,000 — so while it won’t come cheap, that may be the price you have to pay for peace of mind.

Overall, condoms are the most common and most readily available option for worry-free fun in Japan, so whether you are going out with someone for the first or the 50th time, make sure to keep some condoms on hand just in case. One of the main reasons for that is that a popular method of contraception used by many men in Japan is the dubious withdrawal method — which, for obvious reasons, does not protect against STDs/STIs or pregnancy.

If you go out with a Japanese man, this may be the method he prefers, so ladies, please keep yourself safe and have some condoms stored safely in your purse.